Showing codes M0245 (Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring) — M1022 (Patients who were in hospice at any time during the performance period)

M0245 - Bamlan and etesev infusion
Long description: Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring
Code added date: 20210209.
Code effective date: 20210209.
Pricing Indicator Code(s): 54 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M0246 - Bamlan and etesev infus home
Long description: Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider based to the hospital during the covid 19 public health emergency
Code added date: 20210506.
Code effective date: 20210506.
Pricing Indicator Code(s): 54 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M0247 - Sotrovimab infusion
Long description: Intravenous infusion, sotrovimab, includes infusion and post administration monitoring
Code added date: 20210526.
Code effective date: 20210526.
Pricing Indicator Code(s): 54 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M0248 - Sotrovimab inf, home admin
Long description: Intravenous infusion, sotrovimab, includes infusion and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency
Code added date: 20210526.
Code effective date: 20210526.
Pricing Indicator Code(s): 54 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M0249 - Adm tocilizu covid-19 1st
Long description: Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administration monitoring, first dose
Code added date: 20210624.
Code effective date: 20210624.
Pricing Indicator Code(s): 54 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M0250 - Adm tocilizu covid-19 2nd
Long description: Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administration monitoring, second dose
Code added date: 20210624.
Code effective date: 20210624.
Pricing Indicator Code(s): 54 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M0300 - Iv chelationtherapy
Long description: Iv chelation therapy (chemical endarterectomy)
Code added date: 19860101.
Code effective date: 19960101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: M (A code denoting Medicare coverage status).
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M0301 - Fabric wrapping of aneurysm
Long description: Fabric wrapping of abdominal aneurysm
Code added date: 19860101.
Code effective date: 20040101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: M (A code denoting Medicare coverage status).
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M1000 - Pain scr as mod to sevr
Long description: Pain screened as moderate to severe
Code added date: 20190101.
Code effective date: 20200101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1001 - Pln to adrs pain doc
Long description: Plan of care to address moderate to severe pain documented on or before the date of the second visit with a clinician
Code added date: 20190101.
Code effective date: 20200101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1002 - Pln to adrs pain not doc
Long description: Plan of care for moderate to severe pain not documented on or before the date of the second visit with a clinician, reason not given
Code added date: 20190101.
Code effective date: 20200101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1003 - Tb scr 12 mo pri fst bio dz
Long description: Tb screening performed and results interpreted within twelve months prior to initiation of first-time biologic and/or immune response modifier therapy
Code added date: 20190101.
Code effective date: 20230101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1004 - Doc med rsn no srn tb
Long description: Documentation of medical reason for not screening for tb or interpreting results (i.e., patient positive for tb and documentation of past treatment; patient who has recently completed a course of anti-tb therapy)
Code added date: 20190101.
Code effective date: 20190101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1005 - Tb scr no perf
Long description: Tb screening not performed or results not interpreted, reason not given
Code added date: 20190101.
Code effective date: 20190101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1006 - Dz not ases, no rsn
Long description: Disease activity not assessed, reason not given
Code added date: 20190101.
Code effective date: 20190101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1007 - >=50% total pt outpt ra enct
Long description: >=50% of total number of a patient's outpatient ra encounters assessed
Code added date: 20190101.
Code effective date: 20190101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1008 - <50% total pt outpt ra encts
Long description: <50% of total number of a patient's outpatient ra encounters assessed
Code added date: 20190101.
Code effective date: 20190101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1009 - Dc eoc doc med rec
Long description: Discharge/discontinuation of the episode of care documented in the medical record
Code added date: 20190101.
Code effective date: 20200101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1010 - Dc eoc doc med rec
Long description: Discharge/discontinuation of the episode of care documented in the medical record
Code added date: 20190101.
Code effective date: 20200101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1011 - Dc eoc doc med rec
Long description: Discharge/discontinuation of the episode of care documented in the medical record
Code added date: 20190101.
Code effective date: 20200101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1012 - Dc eoc doc med rec
Long description: Discharge/discontinuation of the episode of care documented in the medical record
Code added date: 20190101.
Code effective date: 20200101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1013 - Dc eoc doc med rec
Long description: Discharge/discontinuation of the episode of care documented in the medical record
Code added date: 20190101.
Code effective date: 20200101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1014 - Dc epi care doc medrec
Long description: Discharge/discontinuation of the episode of care documented in the medical record
Code added date: 20190101.
Code effective date: 20200101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1015 - Dc eoc doc med rec
Long description: Discharge/discontinuation of the episode of care documented in the medical record
Code added date: 20190101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1016 - Pt dx meop or sur steri
Long description: Female patients unable to bear children
Code added date: 20190101.
Code effective date: 20190101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1017 - Pt admt to palitve serv
Long description: Patient admitted to palliative care services
Code added date: 20190101.
Code effective date: 20230101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1018 - Pt dx hst cr pt sk lg cr scr
Long description: Patients with an active diagnosis or history of cancer (except basal cell and squamous cell skin carcinoma), patients who are heavy tobacco smokers, lung cancer screening patients
Code added date: 20190101.
Code effective date: 20190101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1019 - Adl pt mj dep ds rs 12 phq<5
Long description: Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5
Code added date: 20190101.
Code effective date: 20190101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1020 - Adl pt mj dep ds no rs 12 mo
Long description: Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5. either phq-9 or phq-9m score was not assessed or is greater than or equal to 5
Code added date: 20190101.
Code effective date: 20190101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1021 - Pt uc in pp
Long description: Patient had only urgent care visits during the performance period
Code added date: 20190101.
Code effective date: 20190101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1022 - Pt hospice during perf pd
Long description: Patients who were in hospice at any time during the performance period
Code added date: 20190101.
Code effective date: 20220101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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